{"id":62975,"date":"2016-02-24T21:59:08","date_gmt":"2016-02-24T19:59:08","guid":{"rendered":"http:\/\/www.sorubak.com\/blog\/?p=62975"},"modified":"2016-02-24T21:59:08","modified_gmt":"2016-02-24T19:59:08","slug":"cocuklarda-idrar-kacirma-nedenleri-belirtileri-tedavisi","status":"publish","type":"post","link":"https:\/\/www.sorubak.com\/blog\/cocuklarda-idrar-kacirma-nedenleri-belirtileri-tedavisi.html","title":{"rendered":"\u00c7ocuklarda idrar ka\u00e7\u0131rma nedenleri, belirtileri, tedavisi"},"content":{"rendered":"<h3><u>\u00c7OCUKLARDA \u0130DRAR KA\u00c7IRMA (EN\u00dcREZ\u0130S)<\/u><u>\u00a0<\/u><\/h3>\n<p>\u00c7ocuklar\u0131n \u00e7o\u011fu 3-4 ya\u015flar\u0131nda, uyan\u0131k olduklar\u0131 d\u00f6nemde idrar\u0131n\u0131 tutabilirler. \u0130stemli kontrol\u00fcn beklenebilece\u011fi bir ya\u015fta olu\u015fan; \u0130stemd\u0131\u015f\u0131, ve tekrarlay\u0131c\u0131 idrar ka\u00e7\u0131rma olay\u0131na en\u00fcrezis denir.<\/p>\n<p><strong>En\u00fcrezisin iki tipi mevcuttur:<\/strong><\/p>\n<ol>\n<li><strong> )Birincil en\u00fcrezis :<\/strong>Bir \u00e7ocuk uzun s\u00fcre boyunca hi\u00e7 idrar\u0131n\u0131\u00a0tutam\u0131yor ise bu \u015fekilde adland\u0131r\u0131l\u0131r.<\/li>\n<li><strong> )\u0130kincil en\u00fcrezis:<\/strong>Uzun bir s\u00fcre kontroll\u00fc idrar yapmas\u0131na kar\u015f\u0131n, 6-9 ayl\u0131k bir periyotluk s\u00fcre zarf\u0131nda idrar\u0131n\u0131 tutam\u0131yor ise\u00a0bu isim verilir.<\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.sorubak.com\/blog\/wp-content\/uploads\/2016\/02\/idrar-ka\u00e7\u0131rma.jpg\" rel=\"attachment wp-att-62976\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-62976\" src=\"https:\/\/www.sorubak.com\/blog\/wp-content\/uploads\/2016\/02\/idrar-ka\u00e7\u0131rma.jpg\" alt=\"idrar ka\u00e7\u0131rma\" width=\"333\" height=\"240\" srcset=\"https:\/\/www.sorubak.com\/blog\/wp-content\/uploads\/2016\/02\/idrar-ka\u00e7\u0131rma.jpg 333w, https:\/\/www.sorubak.com\/blog\/wp-content\/uploads\/2016\/02\/idrar-ka\u00e7\u0131rma-300x216.jpg 300w\" sizes=\"auto, (max-width: 333px) 100vw, 333px\" \/><\/a>En s\u0131k rastlanan tip ise nokturna en\u00fcrezis (Gece i\u015femeleri) dir.<strong>\u00a0<\/strong><\/p>\n<ul>\n<li>Alt\u0131 ya\u015f\u0131n\u0131n alt\u0131ndaki \u00e7ocuklarda %15-30 unda (erkek \u00e7ocuklarda ve zenci \u00e7ocuklarda daha s\u0131k g\u00f6r\u00fcl\u00fcr)<\/li>\n<li>12 ya\u015f\u0131ndaki \u00e7ocuklar\u0131n %4-16\u2019s\u0131nda,en az\u0131ndan bir defa yatak \u0131slatma olay\u0131 olmu\u015ftur<\/li>\n<li>4 ya\u015f\u0131ndan sonra olu\u015fan en\u00fcrezis olgular\u0131n\u0131n %20&#8217;si ikincil en\u00fcrezistir ve bu durumda dikkatli inceleme gereklidir.<\/li>\n<li>6-12 ya\u015f grubu \u00e7ocuklar\u0131n %1&#8217;inde ise g\u00fcnd\u00fcz en\u00fcrezisi mevcuttur.<\/li>\n<\/ul>\n<p><strong>EN\u00dcREZ\u0130S\u0130N NEDENLER\u0130<\/strong><\/p>\n<p><strong>Primer en\u00fcreziste neden:<\/strong><\/p>\n<ul>\n<li>Primer en\u00fcrezisli \u00e7ocuklar\u0131n %5\u2019inden az\u0131nda, primer nokturnal en\u00fcrezisli \u00e7ocuklar\u0131n %1-2\u2019 inde olay\u0131n sebebi organik bir nedendir.<\/li>\n<li>Hemen hemen t\u00fcm primer en\u00fcrezisli olgular\u0131n nedeni \u00fcreter sfinkter kontrol olgunla\u015fmas\u0131n\u0131n gecikmesidir. Bu olgunla\u015fma eksikli\u011fine birde anne baba ve \u00e7ocu\u011fun bu sorun konusundaki kayg\u0131lar\u0131na ba\u011fl\u0131 psikolojik durumlar\u0131 eklenince olay daha da uzar.<\/li>\n<\/ul>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u0130kincil en\u00fcreziste neden:<\/strong><\/p>\n<p><strong>1.)<\/strong>\u00a0\u00a0Psikolojik olarak stresli bir olay\u0131n ya\u015fanmas\u0131.<\/p>\n<ol start=\"2\">\n<li><strong>)<\/strong>Organik bir nedene ba\u011fl\u0131 olmas\u0131 olay\u0131, birincil en\u00fcrezisten y\u00fcksektir bunlar \u015funlard\u0131r:<\/li>\n<\/ol>\n<ul>\n<li>\u0130drar yolu enfeksiyonu.(En s\u0131k g\u00f6r\u00fclen organik neden)<\/li>\n<li>Kimyasal distal \u00fcretrit (\u00d6r: k\u00f6p\u00fckl\u00fc su ile banyo yap\u0131lmas\u0131na ba\u011fl\u0131)<\/li>\n<\/ul>\n<p><strong>Not:<\/strong><strong>\u00a0<\/strong>\u00dcretra;<strong>\u00a0<\/strong>\u0130drar\u0131 idrar kesesinden d\u0131\u015far\u0131 ortama ta\u015f\u0131yan\u00a0idrar yoluna verilen isimdir.<\/p>\n<ul>\n<li>Do\u011fumsal idrar yollar\u0131 anomalileri.<\/li>\n<li>Alt \u00fcriner sistem darl\u0131\u011f\u0131 (\u00dcretral kist vs..)<\/li>\n<li>Ektopik \u00fcreter (Normal olmas\u0131 gereken yerden farkl\u0131 yerle\u015fimli \u00fcreter)<\/li>\n<li>\u015eeker hastal\u0131\u011f\u0131n\u0131n varl\u0131\u011f\u0131.<\/li>\n<li>Bat\u0131n i\u00e7inde kitlesel olu\u015fumlar\u0131n varl\u0131\u011f\u0131.<\/li>\n<\/ul>\n<p><strong>\u0130DRAR KA\u00c7IRMA OLAYI E\u011eER ORGAN\u0130K B\u0130R NEDENE BA\u011eLI \u0130SE \u015eU BEL\u0130RT\u0130LERDE G\u00d6ZLENEB\u0130L\u0130R<\/strong><\/p>\n<ul>\n<li>\u0130drar yaparken yanma.<\/li>\n<li>S\u0131k s\u0131k idrara \u00e7\u0131kma.<\/li>\n<li>Kanl\u0131 idrar yapma.<\/li>\n<li>K\u00fc\u00e7\u00fck \u00e7apl\u0131 idrar ak\u0131nt\u0131s\u0131 ve ya damlatma.<\/li>\n<li>Stres inkontinans (\u00d6ks\u00fcr\u00fck, a\u011f\u0131r kald\u0131rma vs..an\u0131nda idrar ka\u00e7\u0131rma)<\/li>\n<li>Y\u00fcr\u00fcme bozuklu\u011fu<\/li>\n<\/ul>\n<p><strong>GECE \u0130\u015eEMELER\u0130\u00a0( EN\u00dcREZ\u0130S NOKTURNA)<\/strong>\u00a0<strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/strong><\/p>\n<p>\u0130stemli kontrol\u00fcn beklenebilece\u011fi bir ya\u015fta uyku s\u0131ras\u0131nda olu\u015fan istemd\u0131\u015f\u0131 ve tekrarlay\u0131c\u0131 idrar ka\u00e7\u0131rma olay\u0131na en\u00fcrezis denir.<\/p>\n<ul>\n<li>4 ya\u015f\u0131ndaki \u00e7ocuklar\u0131n % 30\u2019unda<\/li>\n<li>6 ya\u015f\u0131ndaki \u00e7ocuklar\u0131n %10\u2019unda<\/li>\n<li>12 ya\u015f\u0131ndaki \u00e7ocuklar\u0131n % 3\u2019\u00fcnde<\/li>\n<li>18 ya\u015f\u0131ndaki \u00e7ocuklar\u0131n %1\u2019inde g\u00f6r\u00fcl\u00fcr.<\/li>\n<\/ul>\n<p><strong>Risk fakt\u00f6rleri:<\/strong><\/p>\n<ul>\n<li>Erkeklerde k\u0131zlardan daha s\u0131k g\u00f6r\u00fcl\u00fcr.<\/li>\n<li>Ailesel ge\u00e7i\u015f saptanm\u0131\u015ft\u0131r.<\/li>\n<li>Bazen uyku bozukluklar\u0131 olaya e\u015flik eder.( \u00d6r:Uyurgezerlik ve gece korkular\u0131)<\/li>\n<li>Olgular\u0131n yanl\u0131zca %1-2&#8217;sinde organik bir neden saptanm\u0131\u015ft\u0131r. En s\u0131k organik neden ise idrar yolu enfeksiyonudur. (Di\u011fer organik nedenler normal en\u00fcrezis ba\u015fl\u0131\u011f\u0131 alt\u0131nda anlat\u0131lm\u0131\u015ft\u0131r)<\/li>\n<li>Seyrek olarak da\u00a0orta ve a\u011f\u0131r derecede bireysel ve ailesel psikopatolojiye ba\u011fl\u0131 olarak meydana gelir. Bu durumda hastan\u0131n bir\u00a0psikiyatriste gitmesi \u015fartt\u0131r.<\/li>\n<\/ul>\n<p><strong>EN\u00dcRES\u0130S\u0130N TEDAV\u0130S\u0130<\/strong><\/p>\n<ul>\n<li>Hasta alt\u0131 ya\u015f\u0131ndan k\u00fc\u00e7\u00fck ise kendili\u011finden iyile\u015fme oran\u0131 y\u00fcksek oldu\u011fu i\u00e7in tedavi \u00f6nerilmez.<\/li>\n<li>Alt\u0131 ya\u015f\u0131nda sonra bile birincil en\u00fcrezisin kendili\u011finden iyile\u015fme oran\u0131 %15 dir. \u0130kincil en\u00fcreziste de bu oran \u00e7ok y\u00fcksektir. (E\u011fer organik bir nedene ba\u011fl\u0131 de\u011filse)<\/li>\n<li>Organik bir neden s\u00f6z konusu ise nedene y\u00f6nelik bir tedavi se\u00e7ilmelidir.<\/li>\n<\/ul>\n<p><strong>S\u0131k\u00e7a kullan\u0131lan \u00fc\u00e7 tedavi y\u00f6ntemi vard\u0131r:<\/strong><\/p>\n<p><strong>I.) En\u00fcrezis dan\u0131\u015fmanl\u0131\u011f\u0131:<\/strong>\u00a0Bu sistemde a\u015fa\u011f\u0131daki \u00f6nerilere uyulmal\u0131d\u0131r.<\/p>\n<p><u>\u00c7ocuk kendisi aktif bir rol \u00fcslenir ve:<\/u><\/p>\n<ul>\n<li>Alt\u0131n\u0131 \u0131slatt\u0131\u011f\u0131 ve kuru kald\u0131\u011f\u0131 geceleri bir takvim d\u00fczenleyerek not al\u0131r.<\/li>\n<li>Bu konuda doktoru ile kendisi konu\u015fur.<\/li>\n<li>Gece yatmadan \u00f6nce mutlaka idrar\u0131n\u0131 yapmal\u0131d\u0131r.<\/li>\n<li>Yatma saatinden 2-3 saat \u00f6ncesinden itibaren s\u0131v\u0131 \u015feyleri almamal\u0131d\u0131r.<\/li>\n<li>\u00c7ocuk cezaland\u0131r\u0131lmaz ve anne-baba k\u0131zg\u0131n tepkiler vermekten ka\u00e7\u0131n\u0131r.<\/li>\n<li>\u00c7ocu\u011fun alt\u0131n\u0131 \u0131slatmad\u0131\u011f\u0131 geceler i\u00e7in \u00f6d\u00fcllendirme yap\u0131l\u0131r.<\/li>\n<li>En\u00fcrezisin nedenleri ve seyri hakk\u0131nda g\u00fcvence verilir. (Ama\u00e7 utan\u00e7 ve su\u00e7luluk hislerinin giderilmesidir)<\/li>\n<\/ul>\n<p><strong>II.) G\u00fcn\u00fcm\u00fczde en etkili tedavi y\u00f6ntemlerinden birisi en\u00fcrezis alarmlar\u0131d\u0131r:<\/strong><\/p>\n<ul>\n<li>Bu y\u00f6ntem ile iyile\u015fme oranlar\u0131 %70 civar\u0131ndad\u0131r, tekrarlama oranlar\u0131 ise 5-15 ya\u015flar\u0131 aras\u0131nda %10-15 civar\u0131ndad\u0131r. Tam ba\u015far\u0131 sa\u011flanmas\u0131 bazen aylarca s\u00fcrebilir.<\/li>\n<li>Bu alarm sisteminin kurulmas\u0131 kolay olup sistem bir iki\u00a0damla idrar ka\u00e7\u0131r\u0131ld\u0131\u011f\u0131nda harekete ge\u00e7er ve alarm \u00e7alar. \u0130lk\u00a0haftalarda \u00e7ocuk idrar\u0131n\u0131 tamamen ka\u00e7\u0131rd\u0131\u011f\u0131nda uyan\u0131r, bu olaydan bir iki hafta sonra idrar k\u0131smen inhibe olur (bask\u0131lan\u0131r).<\/li>\n<li>Sonu\u00e7ta \u00e7ocuk idrar yapmadan \u00f6nce meydana gelen mesane kas\u0131lmalar\u0131na \u015fartl\u0131 bir yan\u0131t vererek uyan\u0131r.<\/li>\n<li>Alarm\u0131n kullan\u0131lmas\u0131n\u0131n b\u0131rak\u0131lmas\u0131 karar\u0131nda, son yatak \u0131slatma n\u00f6betinin \u00fczerinden \u00fc\u00e7 haftal\u0131k kuru kal\u0131nan d\u00f6nemin ge\u00e7mesi gerekmektedir.<\/li>\n<\/ul>\n<p><strong>III.) \u0130la\u00e7la tedavi:<\/strong><\/p>\n<p>\u0130lk hafta i\u00e7inde y\u00fcksek yan\u0131t oran\u0131na sahiptir ancak ila\u00e7 kullan\u0131m\u0131ndan sonraki d\u00f6nemlerdeki yenileme oran\u0131 o kadar y\u00fcksektir ki, hasta ilac\u0131 b\u0131rakt\u0131\u011f\u0131 zaman uzun s\u00fcreli iyile\u015fme oran\u0131 kendili\u011finden iyile\u015fme oran\u0131n\u0131\u00a0\u00a0seyrek olarak a\u015ft\u0131\u011f\u0131ndan fazla tercih edilmez.<\/p>\n<ul>\n<li>\u0130la\u00e7 olarak imipramin kullan\u0131l\u0131r.<\/li>\n<li>8-12 ya\u015f\u0131ndaki \u00e7ocuklara yat\u0131\u015f saatinden \u00f6nce 50 mg.<\/li>\n<li>12 ya\u015f\u0131ndan b\u00fcy\u00fcklerde yat\u0131\u015f saatinden \u00f6nce 75 mg dozda uygulan\u0131r.<\/li>\n<li>\u0130la\u00e7 tedavisine, idrar ka\u00e7\u0131rma olay\u0131n\u0131n olu\u015fmad\u0131\u011f\u0131 1 ayl\u0131k s\u00fcre sonunda son verilir. \u0130la\u00e7 2-4 hafta i\u00e7erisinde azalt\u0131larak kesilmelidir<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>\u00c7OCUKLARDA \u0130DRAR KA\u00c7IRMA (EN\u00dcREZ\u0130S)\u00a0 \u00c7ocuklar\u0131n \u00e7o\u011fu 3-4 ya\u015flar\u0131nda, uyan\u0131k olduklar\u0131 d\u00f6nemde idrar\u0131n\u0131 tutabilirler. \u0130stemli kontrol\u00fcn beklenebilece\u011fi bir ya\u015fta olu\u015fan; \u0130stemd\u0131\u015f\u0131, ve tekrarlay\u0131c\u0131 idrar ka\u00e7\u0131rma olay\u0131na en\u00fcrezis denir. En\u00fcrezisin iki tipi mevcuttur: )Birincil en\u00fcrezis :Bir \u00e7ocuk uzun s\u00fcre boyunca hi\u00e7 idrar\u0131n\u0131\u00a0tutam\u0131yor ise bu \u015fekilde adland\u0131r\u0131l\u0131r. )\u0130kincil en\u00fcrezis:Uzun bir s\u00fcre kontroll\u00fc idrar yapmas\u0131na kar\u015f\u0131n, 6-9 ayl\u0131k bir &#8230; <a title=\"\u00c7ocuklarda idrar ka\u00e7\u0131rma nedenleri, belirtileri, tedavisi\" class=\"read-more\" href=\"https:\/\/www.sorubak.com\/blog\/cocuklarda-idrar-kacirma-nedenleri-belirtileri-tedavisi.html\" aria-label=\"More on \u00c7ocuklarda idrar ka\u00e7\u0131rma nedenleri, belirtileri, tedavisi\">Devam\u0131n\u0131 oku&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20865],"tags":[],"class_list":["post-62975","post","type-post","status-publish","format-standard","hentry","category-saglik-kosesi"],"_links":{"self":[{"href":"https:\/\/www.sorubak.com\/blog\/wp-json\/wp\/v2\/posts\/62975","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.sorubak.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.sorubak.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.sorubak.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.sorubak.com\/blog\/wp-json\/wp\/v2\/comments?post=62975"}],"version-history":[{"count":0,"href":"https:\/\/www.sorubak.com\/blog\/wp-json\/wp\/v2\/posts\/62975\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.sorubak.com\/blog\/wp-json\/wp\/v2\/media?parent=62975"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.sorubak.com\/blog\/wp-json\/wp\/v2\/categories?post=62975"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.sorubak.com\/blog\/wp-json\/wp\/v2\/tags?post=62975"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}